title: The rapid response system and end-of-life care.
abstract: OBJECTIVE
  To review the recent observational studies reporting the role of the rapid response team (RRT) in end-of-life care (EOLC) planning for hospitalized patients.
  
  
  RESULTS
  Initial RRT studies focussed on its role in detecting and preventing avoidable morbidity. However, patients who are in the process of dying will also trigger RRT activation criteria. Single-centre studies from several countries reveal that up to 25% of RRT calls involve patients with a pre-existing limitation of medical therapy (LOMT) and 10% result in new implementation of a new LOMT. A recent seven hospital study revealed that such EOLC RRT calls occur in significantly older patients, who are less likely to be from home and more likely to be admitted with a nonsurgical condition. Importantly, almost 50% of patients subject to EOLC RRT call die in hospital, and in many cases the last RRT call occurs on the day of death.
  
  
  CONCLUSIONS
  Up to one-third of RRT calls involve patients at the end of their life. Better understanding of the features of these patients may guide improved advance care and EOLC planning for hospitalized patients.
authors.affiliation: aAustin Hospital, Heidelberg, Victoria, Australia bDepartment of Anesthesiology and Critical Care Medicine, Armstrong Institute for Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA cCritical Care, University College London Hospitals NHS Foundation Trust dCity University, London, UK.
authors.forename: Daryl
authors.initials: D
authors.lastname: Jones
authors.forename: Juli
authors.initials: J
authors.lastname: Moran
authors.forename: Bradford
authors.initials: B
authors.lastname: Winters
authors.forename: John
authors.initials: J
authors.lastname: Welch
mesh_terms: D003142:Communication; D016638:Critical Illness / Q000628:therapy*; D005260:Female; D017052:Hospital Mortality; D057209:Hospital Rapid Response Team; D006801:Humans; D008297:Male; D010347:Patient Care Planning / Q000458:organization & administration* / Q000639:trends; D018579:Patient Selection; D010819:Physician's Role; D011787:Quality of Health Care; D011788:Quality of Life; D016414:Resuscitation Orders; D013727:Terminal Care